重庆市HIV 感染者和AIDS病人生存质量和医疗需求调查分析

目的了解艾滋病病毒(HIV)感染者和艾滋病(AIDS)病人的生存状况、求医行为和医疗需求,为制定相关的救治救助政策提供可靠的依据。方法对HIV感染者和AIDS病人进行面对面的问卷调查,资料用SPSS12.0统计分析。结果调查的122例HIV感染者和AIDS病人以经静脉吸毒感染为主,其次是性接触和血源感染。感染HIV后经济收入和生活水平都明显下降,感染HIV后失去主要的经济来源和巨额的医疗费用是导致生活水平下降的主要原因,而医疗费用主要由自己承担(除抗病毒治疗药物和CD4检测费用外)。他们的生存质量评分均在50分左右。结论HIV感染者和AIDS病人因感染HIV经济收入明显减少,医疗需求明显增加,生活水平明显下降,生活质量差。     

33例HIV/AIDS病人的生活质量与影响因素

目的了解艾滋病病毒（HIV）感染者/艾滋病（AIDS）病人（简称HIV/AIDS病人）的生活质量及其影响因素,为社会支持提供依据。方法选择陕西省山阳县、武功县HIV/AIDS病人33例,采用世界卫生组织生活质量量表（WHOQOL-BREF）对其进行调查,对相关数据进行描述性统计和多重线性回归分析。结果超过半数调查对象感染HIV后感到羞愧、自责、痛苦、恐惧、绝望,且山阳县HIV/AIDS病人感到羞愧和自责的比例显著高于武功县。一半以上的HIV/AIDS病人认为自己的生活质量一般。约1/3的HIV/AIDS病人对自身的健康状况满意。健康状况的主观感受、心理领域得分和参加活动3个因素影响HIV/AIDS病人的生活质量,并且3个因素均为正向影响因素。结论鼓励与支持HIV/AIDS病人积极参加社会活动,提高其对健康状况的主观感受,促进心理健康,均能提高他们的生活质量。     

哈尔滨市HIV/AIDS病人抗病毒治疗服药依从性的相关研究

目的探讨哈尔滨市艾滋病病毒（HIV）感染者/艾滋病（AIDS）病人（HIV/AIDS病人）服药依从性现状以及相关的影响因素。方法横断面调查研究,采用人口学问卷、服药依从性量表、AIDS耻辱量表等收集信息,运用SPSS 13.0统计软件进行数据分析。结果共调查104名HIV/AIDS病人,在耻辱量表、症状量表、敌意心理趋势、经济费用担忧以及医生信任度方面的得分,分别为（33.83±3.98）分、（18.64±15.16）分、（83.57±19.65）分、（45.51±29.31）分及（73.20±23.78）分;病人在过去的7天内平均服药依从性为90.24%;41.35%的病人在过去1个月内曾发生过漏服药物;多因素Logistic回归分析显示,年龄、婚姻状况、感染途径、AIDS耻辱得分,以及经济费用担忧得分对服药依从性有影响（P〈0.05）。结论有近一半HIV/AIDS病人存在漏服药物的现象,必须采取综合性干预措施,提高HIV/AIDS病人的服药依从性。     

HIV感染者和AIDS病人生活质量的影响因素

研究艾滋病病毒（HIv）感染者和艾滋病（AIDS）病人的生活质量,有着特殊的含义和重要性。艾滋病抗病毒治疗的应用,不但大大降低了HIV感染者和病人的死亡率,而且有效地提高了HIV感染者和病人的生活质量。然而影响HIV感染者和病人生活质量的因素是多方面的,包括社会人口学特征、疾病及疾病相关因素、社会心理因素等。同时,改善社会支持也是提高他们生活质量的途径之一。     

耻辱和歧视对艾滋病防治工作的负面影响

与艾滋病相关的耻辱和歧视（AIDS-related stigma and discrimination）是指对艾滋病病毒（HIV）感染者／艾滋病（AIDS）病人及相关人群、相关行为的歧视，也包括高危人群及其家人等的羞耻感和自我歧视。目前，与艾滋病相关的耻辱和歧视已经渗透到社会的各个领域，包括政策、法律法规、医疗服务、就业、教育、社区、家庭等环境中。     

艾滋病与结核病双重感染的研究

目的 调查HIV感染者和AIDS感染结核杆菌情况，了解HIV／AIDS与结核病的相关性。方法 对202例健康者及40例经WB确证的HIV感染和AIDS病人做结核菌素（PPD）试验，CD4、CD8淋巴细胞储数。结果 HIV感染者和AIDS病人中PPD阳性率12．5％，而健康对照PPDB阳性率28．2％（P＜0．05）。CD4细胞计数＜200/mm^3者PPD均为阴性。CD4／CD8比值＜1者达90％。结论 HIV感染者和AIDS病人机体免疫力降低，PPD反应明显下降。对HIV／KAIDS病人使用化学药物预防以控制和减少结核病发病及制定相关政策提供依据。     

云南省616例艾滋病病毒感染者死亡报告的临床临床表现分析

目的：通过分析云南省艾滋病病毒（HIV）感染者死亡报告的临床表现和死因，为HIV感染者的关怀提供参考。方法：用EPI软件进行资料的输入和数据处理。结果：（1）报告死亡数呈逐年上升趋势。（2）在616例HIV感染死亡者中，354例具有死亡报告中所列的主要症状，进行性体重下降上95．2％（337／354），持续发热占72．3％（256／354），持续腹泻占51．1％（181／354）。（3）在290例具有次要临床表现的HIV感染死亡者中，持续性咳嗽者79．3％（230／290），口腔白色念珠菌感染占25．2％（73／290），持续性全身淋巴结肿大占19．3％（56／290），全身多形性皮疹占12．1％（35／290）。（4）在106例具有特殊临床表现的HIV感染死亡者中，结核病占54．7％（58／106），神经系统病变占44．3％（47／106）。此外，报告的HIV感染死亡者，一般情况较差，具有乏力，纳差，极度消瘦乃至恶病质，占死亡者报告的占87．4％（188／215）。（5）艾滋病（AIDS）和疑似AIDS是HIV感染的主要死因，占57．8％（356／616）；吸毒过量占20．6％（127／616），艾滋病相关综合征（ARC）和非疾病因素（自杀、意外伤害和打架）分别占了6．0％（37／616）和6．3％（39／616）；1．5％（9／616）死于疟疾，注射假毒品和引产，有63．3％（390／616）的HIV感染者在诊断HIV感染或AIDS时已经死亡。81．1％（353／435）的HIV感染者死于家中，4．65（20／435）死于医院，14．3％（62／435）死于其它地方。还有181例死亡地点不详。结论：云南省HIV感染者的死亡呈逐年上升趋势，HIV感染者急需得到医疗和翔服务。开展抗病毒治疗和控制HIV感染者的各种机会性感染，加强健康教育和减少毒品危害，加强对HIV感染者的社会和家庭关怀，加强基层对HIV／AIDS的识别诊断能力，早发现和早治疗是降低HIV／AIDS病死率，提高感染者生命质量的重要措施。     

湖北省HIV感染者/AIDS病人现况分析

目的探讨未接受过抗病毒治疗的艾滋病病毒感染者/艾滋病(HIV／AIDS)病人的发病和存活情况。方法采用横断面调查方法对湖北省671例HIV／AIDS病人进行随访调查，对调查资料进行Logistic回归分析、生存分析等。结果湖北省HIV／AIDS病人的男女性别比为1．37：1；治疗前的AIDS病人病死率为29．81％；HIV感染者中发病足引起死亡的危险因素；婚姻状况町明显影响HIV／AIDS病人的生存。结论HIV／AIDS病人急待社会医疗、心理、乍活等各方面的救助；维持HIV／AIDS病人的家庭稳定可延长其生存时间。     

2014年8月全国艾滋病性病疫情及主要防治工作进展

一、艾滋病（AIDS）疫情报告情况截至2014年8月31日,全国报告现存活艾滋病病毒（HIV）感染者/AIDS病人490 521例,死亡149347例。现存活HIV感染者297 355例,AIDS病人193 166例。本月新发现HIV感染者/AIDS病人9512例。本月新发现HIV感染者／AIDS病人9512例,既往HIV感染者本月转化为AIDS病人2557例。本月报告死亡1799例中,本月死亡857例,既往死亡942例。本月新发现的HIV感染者／AIDS病人中,HIV感染者男女之比为3．6：1,AIDS病人男女之比为3．8：1;15岁以下HIV感染者88例,AIDS病人8例。     

2012年12月全国艾滋病性病疫情及主要防治工作进展

一、艾滋病（AIDS）疫情截至2012年12月31日,全国报告现存活艾滋病病毒（HIV）感染者／AIDS病人385817例,死亡114787例。现存活HIV感染者240174例,AIDS病人145643例。本年新发现HIV感染者／AIDS病人82434例,     

安徽省临泉县艾滋病社区关爱体系调查研究

目的了解皖北农村地区艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人及其亲属的生活质量和社会支持现状,分析其相关的影响因素。同时了解当地各阶层健康居民关于艾滋病的相关知识、态度、行为(KAP)。方法通过典型抽样法对85名HIV感染者和病人及65名HIV感染者和病人家属进行调查,经分层抽样方法对519名社会各阶层健康居民进行调查。结果不同性别、不同文化程度的HIV感染者和病人及其家属生活质量评分差异有显著的统计学意义(P<0.05);不同乡镇的HIV感染者和病人社会支持评分差异有显著的统计学意义(P<0.05)。负性生活事件是影响HIV感染者和病人及其家属社会支持的不利因素,而好的邻里关系、烦恼诉说是影响HIV感染者和病人生活质量的有利因素。KAP调查中,有76.3%的人没有帮助过艾滋病患者,11.3%的人不愿意长期援助艾滋病患者,42.4%的人则看情况。结论诸多因素在不同层面影响皖北农村地区HIV感染者和病人及其亲属的生活质量和社会支持,我国农村现有的艾滋病社区关爱、社会支持工作还亟需加大力度。     

Relationship Among HIV-Related Stigma,Mental Health and Quality of life for HIV-Positive Patients in Tehran

People living with HIV/AIDS (PLHA) face several challenges in terms of the medical management of their disease. Alongside this are stigma, discrimination and psychosocial issues associated with HIV infection. In this study, the relationships associated with HIV-related stigma, mental health and quality of life for HIV-positive patients were investigated. This cross-sectional study examined a sample of 450 HIV positive patients from the Infectious Diseases and Behavioral Health Clinic of Imam Khomeini Hospital in the city of Tehran, Iran. PLWHA completed Socio-Demographic Characteristics, Berger Scale Stigma (BSS), General Health Questionnaire (GHQ-28), WHO Quality of life-BREF (WHOQOL-BREF) and Philips Social Support Appraisals (SSA). Stigma was significantly correlated with psychological variables, social support, and quality of life. A prevalence of psychiatric disorders was reported by 78.8%. Findings suggested that psychosocial interventions reduce HIV related stigma, address psychological disorders and build social support to improve quality of life for people living with HIV.     

山西省运城地区PLWHAS主观幸福感及影响因素的调查研究

目的了解艾滋病病毒（HIV）感染者／艾滋病（AIDs）病人（PLwHAs）的心理状况,探讨影响其主观幸福感的因素。方法选取山西省艾滋病高发地区8个乡镇的194例PLWHAS,用总体幸福感量表（GWB）及影响因素问卷进行调查。结果PLwHAs主观幸福感总体得分（108±11）分,低于普通村民。单因素分析表明,健康状况、身份公开程度、感染年限、社会歧视,是影响PLWHAS主观幸福感的因素（P〈0．05）。目前的社会关怀提升了PLWHAS对生活的满足和兴趣,但对总体主观幸福感作用不显著。结论PLWHAS的主观幸福感受多因素影响,改善其身体健康状况、消除社会歧视等,有助于提升PLWHAS主观幸福感。     

Socioeconomic disadvantage increasing risk for depression among recently diagnosed HIV patients in an urban area in Brazil: cross-sectional study

Depression is the most common psychiatric co-morbidity among people living with HIV (PLHIV), with prevalence rates ranging from 25% to 36%. Depression impacts negatively upon adherence and response to combined antiretroviral therapy (CART) and the transmission of HIV infection through increased sexually risky behavior. This cross-sectional study presents data from a reference HIV-outpatient service in Dourados (Brazil) that evaluated the association between depressive symptoms, health-related quality of life, and clinical, socioeconomic, and demographic factors in newly diagnosed HIV/AIDS patients. Using the Beck Depression Inventory (BDI), the prevalence of depressive symptoms was 61% with a predominance of self-deprecating and cognitive-affective factors. Depressive symptoms were associated with lower income (p = 0.019) and disadvantaged social class (p = 0.005). Poorer quality of life was related to depressive symptoms (p < 0.0001), low educational level (p = 0.05), and lower income (p = 0.03). These data suggest that socioeconomic factors, including level of income and education, are mediating the risk of depression and poor quality of life of PLHIV. Possible explanations for this effect are discussed, including the possible role of stigma.     

HIV/AIDS病人生活质量评价及影响因素分析

目的评价艾滋病病毒感染者/艾滋病病人(HIV/AIDS病人)的生活质量,并探讨其影响因素。方法对在中国医科大学附属第一医院就诊的289名HIV/AIDS病人,用世界卫生组织生活质量简表(WHOQOL-BREF)进行生活质量评价,并与同期高危人群及健康人群进行对比,通过多元线性回归分析生活质量的相关影响因素。结果 HIV/AIDS病人生活质量的生理、心理、社会关系和环境四个维度的平均得分依次为44.5、58.1、62.6和57.7分。HIV/AIDS病人生活质量显著低于HIV阴性的高危人群以及健康人群(P<0.05)。多元线性回归分析显示,尚未接受抗病毒治疗者、男男性行为人群(MSM)、低收入、低文化程度、缺少家庭支持和食欲差,是HIV/AIDS病人较低生活质量的显著影响因素(P<0.05)。结论 HIV/AIDS病人生活质量较低,尤以MSM人群明显,高效抗病毒治疗可显著提高HIV/AIDS病人生活质量,同时应加强对低文化程度、低收入和缺少家庭支持的MSM人群的医疗和社会支持,提高其生活质量,降低死亡率。     

The “moral career” of perinatally HIV-infected children: revisiting Goffman's concept

HIV-infected children usually live in vulnerable situations, experiencing discrimination and stigma commonly felt by other people living with HIV/AIDS. The present study aims to analyse primary socialisation of HIV-infected children and adolescents recruited from a public health service in Rio de Janeiro (Brazil) as a social process that shapes a new generation of stigmatised and vulnerable persons. Research was informed by an interactionist perspective, focusing on key aspects of HIV-infected children and adolescents life histories under the conceptual frame of Erving Goffman's theories regarding “moral careers”. Goffman defines the making of a moral career as the process through which a person learns that she/he possesses a particular attribute, which may lead her/him to be discredited by members of the surrounding society. We have identified aspects of life histories of HIV-vertically infected children and adolescents for each aspect of “moral career” as described by Goffman, relating them to as family structure, the experience of living HIV within the family, and the position and family role of a given subject. The patterns of “moral career” proposed by Goffman in 1963 were useful in identifying components of HIV-related stigma among children and adolescents. These include gender and social disadvantages, difficulty in coping with a child with a potentially severe disease, orphanhood, abandonment, adoption and disclosure of one's HIV serostatus. Primary socialisation of HIV-infected children and adolescents is a key piece of the complex HIV/AIDS-labelling process that could be targeted by interventions aiming to decrease stigma and marginalisation. Health care workers and stakeholders should be committed to ensuring education and guaranteeing the legal rights of this specific population, including the continuous provision of quality health care, full access to school and support to full disclosure of HIV diagnosis.     

A model for understanding the relationship between stigma and healthcare-seeking behaviour among people living with HIV/AIDS in sub-Saharan Africa

People living with HIV or AIDS (PLHIV) in sub-Saharan Africa sometimes have care-seeking behaviours that result in a suboptimal quality of life. This paper seeks to examine the role of stigma in the care-seeking behaviour of PLHIV. We hypothesise that stigma relates to the behaviour of PLHIV themselves and with societal reactions, including those of healthcare professionals. From a literature review, we identified the following as important correlates of care-seeking behavior: beliefs about pathways of HIV infection and people infected with HIV, social reactions, coping strategies, knowledge of HIV and AIDS, and self-efficacy in finding care and treatment in addition to coping with the disease. Poverty, gender, age, religion and policy were found to be moderating variables. The Precede-Proceed model was adapted to build an explanatory model of healthcare-seeking behaviour among PLHIV and particularly to explore the role of stigma in the non-utilisation of healthcare institutions.     

HIV/AIDS knowledge and stigma among women of reproductive age in Ethiopia

HIV/AIDS stigma is one of the major public health challenges in Ethiopia. This study examined knowledge about HIV/AIDS and factors behind stigmatisation towards people living with the virus based on demographic and health survey data collected in 2011 from women in the age group 15–49 years. The result shows that 49.3% of rural women had adequate knowledge about HIV/AIDS compared with 74.7% of urban women. About three-fourths (72.1%) of the rural women had stigmatising attitudes towards PLWHA whilst the proportion in urban areas was only about a third (34.2%). The likelihood of having adequate knowledge about HIV/AIDS was significantly higher among educated women but lower among those living in Afar, Somali, and Gambella regions and Dire Dawa City. Women with higher levels of education and frequent access to media had a lower tendency to stigmatise people living with the virus. Adequate knowledge about HIV/AIDS was also significantly associated with lower likelihood of stigmatisation. The results generally indicate that HIV/AIDS stigma in Ethiopia is partly explained by people's knowledge about HIV/AIDS and by socio-cultural factors that shape their perception of the epidemic. Awareness-raising efforts should thus consider the socio-cultural contexts in which stigma occurs to tackle discrimination against people living with HIV/AIDS.     

我国艾滋病感染者管理的实践与思考

由于社会歧视及自愿咨询检测(Volunlary counseling and testing,VCT)的覆盖率等因素,中国艾滋病疫情估计人数和实际检测报告人数之间还存在较大的差异,提示有大量的传染源——艾滋病感染者尚未被发现。在发现传染源后,由于某些客观原因和人员流动等因素的影响,造成部分已发现的传染源管理丢失。国内一些专业的艾滋病防治机构和非政府组织,对此进行了有益的探索和实践,包括提高随访率、科学横向的感染者管理模式、疾病预防控制机构牵头创建感染者纵向社区管理网络的模式,以人文化管理的模式、非政府组织发挥积极作用的模式以及特定场所的管理模式等,该文对其进展加以综述。